Testosterone: The Male HRT for Andropause

Drug Ther Perspect. 2000;16(10) 

In This Article

Improves Sexual Function

Hypogonadism contributes to the declining sexual function associated with aging. A plasma testosterone level below 2.0 to 4.5 µg/L is associated with impaired sexual behaviour in men.[8] Whether administered intramuscularly, transdermally or orally, testosterone improved both sexual performance and attitude.[9,10]

When men were treated with intramuscular testosterone, then re-treated via the transdermal route (after a testosterone-free withdrawal period), the number of erectile events per day, mean duration of events, and mean penile rigidity increased significantly during the treatment periods compared with the withdrawal period.[9] Libido, arousal, sexual desire, orgasm and satisfaction significantly decreased during the drug-free period, and returned during follow-up treatment.

Oral testosterone undecanoate also improved sexual attitudes and performance in 61% of hypogonadal men with impotence.[10]

The anabolic effects of androgens are well known. Elderly hypogonadal men had increased lean body mass, leg muscle strength[11] and upper body strength[12] after oral or intramuscular testosterone treatment.

In tandem, fat mass was found to decrease after testosterone replacement.[13] Visceral fat declined with testosterone therapy in both patients with acquired hypogonadism and those with abdominal obesity.[1]

For the past 30 years evidence has accumulated demonstrating the benefit of androgens in the treatment of anaemias.[1] For example, when testosterone was administered to older hypogonadal men over a 12-month period, a significant increase in haematocrit values was observed.[12]

In older men, many studies have found that androgen replacement increased the sense of well being, enhanced spatial cognition and had an antidepressant effect.[1]

In contrast, one study has found that in men with erectile dysfunction, biweekly testosterone enanthate had no effect on their affective state or psychological symptoms.[14]

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